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VOLUME 3 , ISSUE 2 ( April-June, 2020 ) > List of Articles

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An Overview of COVID-19: Focus on Pharmacological Aspect

Nandhini Saravanabavan, Manimekalai Kumarappan, Kartik J Salwe, Barathane Datchanamurthy, Johan Pandian, Padmavathi Shanmuganathan, R Sudar Codi, Vimala Ananthy, Kamalasundar Thanuskodi, Uma Narayanamurthy

Citation Information : Saravanabavan N, Kumarappan M, Salwe KJ, Datchanamurthy B, Pandian J, Shanmuganathan P, Codi RS, Ananthy V, Thanuskodi K, Narayanamurthy U. An Overview of COVID-19: Focus on Pharmacological Aspect. 2020; 3 (2):75-79.

DOI: 10.5005/jp-journals-10082-02241

License: CC BY-NC 4.0

Published Online: 09-10-2020

Copyright Statement:  Copyright © 2020; The Author(s).


Abstract

Coronavirus disease 2019 (COVID-19) which has been declared as Public Health Emergency of International Concern by the World Health Organization (WHO) is one of the major disasters in the 21st century. Initially, COVID-19 is called as 2019 novel coronavirus by the Chinese researchers, and later, the disease was named as COVID-19 and the virus as SARS-CoV-2 by the International Committee on Taxonomy of Viruses. It is a single-stranded RNA virus that mainly enters the human cells by angiotensin-converting enzyme 2 (ACE2) receptors like SARS-CoV. The important mode of transmission is through droplets and close contact with the infected people. As soon as the virus enters the human cells, it causes symptoms like cough, fever, headache, and fatigue after an incubation period of 5.2 days. There is no approved treatment or vaccine for this disease so far but many drugs have been tried from the experience obtained while treating SARS-CoV and MERS-CoV. In this article, we discussed the pathogenesis, transmission, clinical features, challenges for control, diagnosis, and treatment advancements to overcome COVID-19.


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  1. Banerjee A, Kulcsar K, Misra V, Frieman M, Mossman K. Bats and coronaviruses. Viruses 2019;11(1):41. DOI: 10.3390/v11010041.
  2. Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: origin, transmission, and characteristics of human coronaviruses. J Adv Res 2020;24:91–98. DOI: 10.1016/j.jare.2020.03.005.
  3. Yang H, Bartlam M, Rao Z. Drug design targeting the main protease, the Achilles’ heel of coronaviruses. Curr Pharm Des 2006;12(35):4573–4590. DOI: 10.2174/138161206779010369.
  4. Belouzard S, Millet JK, Licitra BN, Whittaker GR. Mechanisms of coronavirus cell entry mediated by the viral spike protein. Viruses 2012;4(6):1011–1033. DOI: 10.3390/v4061011.
  5. Schoeman D, Fielding BC. Coronavirus envelope protein: current knowledge. Virol J 2019;16(1):69. DOI: 10.1186/s12985-019-1182-0.
  6. Chang CK, Lo SC, Wang YS, Hou MH. Recent insights into the development of therapeutics against coronavirus diseases by targeting N protein. Drug Discov Today 2016;21(4):562–572. DOI: 10.1016/j.drudis.2015.11.015.
  7. Paules CI, Marston HD, Fauci AS. Coronavirus infections - More than just the common cold. JAMA 2020;323:707. DOI: 10.1001/jama.2020.0757.
  8. Al-Osail AM, Al-Wazzah MJ. The history and epidemiology of Middle East respiratory syndrome corona virus. Multidiscip Respir Med 2017;12:20. DOI: 10.1186/s40248-017-0101-8.
  9. Saif LJ. Animal coronaviruses: what can they teach us about the severe acute respiratory syndrome? Rev Sci Tech 2004;23(2):643–660. DOI: 10.20506/rst.23.2.1513.
  10. Zumla A, Hui DS, Perlman S. Middle East respiratory syndrome. Lancet 2015;386(9997):995–1007. DOI: 10.1016/S0140-6736(15)60454-8.
  11. Chen Y, Liu Q, Guo D. Coronaviruses: genome structure, replication, and pathogenesis. J Med Virol 2020;92(4):418–423. DOI: 10.1002/jmv.25681.
  12. Zhang N, Wang L, Deng X, Liang R, Su M, He C, et al. Recent advances in the detection of respiratory virus infection in humans. J Med Virol 2020;92(4):408–417. DOI: 10.1002/jmv.25674.
  13. Lai C-C, Shih T-P, Ko W-C, Tang H-J, Hsueh P-R. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and corona virus disease-2019 (COVID-19): the epidemic and the challenges. Int J Antimicrob Agents 2020;55(3):1–9. DOI: 10.1016/j.ijantimicag.2020.105924.
  14. WHO. Novel Coronavirus–China. 2020.
  15. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382(8):727–733. DOI: 10.1056/NEJMoa2001017.
  16. WHO. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV) 2020.
  17. Hilgenfeld R. From SARS to MERS: crystallographic studies on coronaviral proteases enable antiviral drug design. FEBS J 2014;281(18):4085–4096. DOI: 10.1111/febs.12936.
  18. Prajapat M, Sarma P, Shekhar N, Avti P, Sinha S, Kaur H, et al. Drug targets for corona virus: a systematic review. Indian J Pharmacol 2020;52(1):56–65. DOI: 10.4103/ijp.IJP_115_20.
  19. Zhang L, Liu Y. Potential interventions for novel coronavirus in China: a systematic review. J Med Virol 2020;92(5):479–490. DOI: 10.1002/jmv.25707.
  20. Jia HP, Look DC, Shi L, Hickey M, Pewe L, Netland J, et al. ACE2 receptor expression and severe acute respiratory syndrome coronavirus infection depend on differentiation of human airway epithelia. J Virol 2005;79(23):14614–14621. DOI: 10.1128/JVI.79.23.14614-14621.2005.
  21. Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by novel coronavirus from Wuhan: an analysis based on decade-long structural studies of SARS. J Virol 2020;94(7):e00127. DOI: 10.1128/JVI.00127-20.
  22. Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak – an update on the status. Mil Med Res 2020;7(1):11. DOI: 10.1186/s40779-020-00240-0.
  23. Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020;579(7798):270–273. DOI: 10.1038/s41586-020-2012-7.
  24. Tortorici MA, Veesler D. Structural insights into coronavirus entry. Adv Virus Res 2019;105:93–116. DOI: 10.1016/bs.aivir.2019.08.002.
  25. de Wilde AH, Snijder EJ, Kikkert M, van Hemert MJ. Host factors in coronavirus replication. Curr Top Microbiol Immunol 2018;419:1–42. DOI: 10.1007/82_2017_25.
  26. Sawicki SG, Sawicki DL. Coronavirus transcription: a perspective. Curr Top Microbiol Immunol 2005;287:31–55. DOI: 10.1007/3-540-26765-4_2.
  27. Letko M, Marzi A, Munster V. Functional assessment of cell entry and receptor usage for SARS-CoV-2 and other lineage B betacoronaviruses. Nat Microbiol 2020;5(4):562–569. DOI: 10.1038/s41564-020-0688-y.
  28. National Health Commission of People's Republic of China. Prevent guideline of 2019-nCoV. 2020.
  29. CDC. 2019 Novel coronavirus, Wuhan, China. 2020.
  30. Gralinski LE, Menachery VD. Return of the coronavirus: 2019-nCoV. Viruses 2020;12(2):135. DOI: 10.3390/v12020135.
  31. Graham RL, Baric RS. Recombination, reservoirs and the molecular spike: mechanisms of coronavirus cross - species transmission. J Virol 2010;84(7):3134–3146.
  32. Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H. First case of 2019 novel coronavirus in the United States. N Engl J Med 2020;382(10):929–936. DOI: 10.1056/NEJMoa2001191.
  33. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun 2020;109:102433. DOI: 10.1016/j.jaut.2020.102433.
  34. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020;382(13):1199–1207. DOI: 10.1056/NEJMoa2001316.
  35. Wang W, Tang J, Wei F. Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China. J Med Virol 2020;92(4):441–447. DOI: 10.1002/jmv.25689.
  36. Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res 2020;7(1):4. DOI: 10.1186/s40779-020-0233-6.
  37. Ren LL, Wang YM, Wu ZQ, Xiang ZC, Guo L, Xu T. Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study. Chinese Med J (Engl) 2020;133(9):1015–1024. DOI: 10.1097/CM9.0000000000000722.
  38. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223):497–506. DOI: 10.1016/S0140-6736(20)30183-5.
  39. Carlos WG, Dela Cruz CS, Cao B, Pasnick S, Jamil S. Novel Wuhan (2019-nCoV) coronavirus. Am J Respir Crit Care Med 2020;201(4):P7–P8. DOI: 10.1164/rccm.2014P7.
  40. Lei J, Li J, Li X, Qi X. CT imaging of the 2019 novel coronavirus (2019-nCoV) pneumonia. Radiology 2020;295(1):18. DOI: 10.1148/radiol.2020200236.
  41. Lee N, Hui D, Wu A, Chan P, Cameron P, Joynt GM. A major outbreak of severe acute respiratory syndrome in Hong Kong. N Engl J Med 2003;348(20):1986–1994. DOI: 10.1056/NEJMoa030685.
  42. Wei Q, Ren Z. Disinfection measures for pneumonia foci infected by novel coronavirus in 2019. Chin J Disinfect 2020;37:59–62.
  43. Raoult D, Zumla A, Locatelli F, Ippolito G, Kroemer G. Coronavirus infections: epidemiological, clinical and immunological features and hypotheses. Cell Stress 2020;4(4):66–75. DOI: 10.15698/cst2020.04.216.
  44. National Health Commission of People's Republic of China. Pneumonia diagnosis and treatment of 2019-nCoV infection from Chinese NHC and CDC 2020. 2020. http://www.nhc.gov.cn/xcs/zhengcwj/202001/4294563ed35b43209b31739bd0785e67/files/7a9309111267475a99d4306962c8bf78.pdf. (Accessed on 1 Feb 2020).
  45. Sarma P, Prajapat M, Avti P, Kaur H, Kumar S, Medhi B. Therapeutic options for the treatment of 2019-novel coronavirus: an evidence-based approach. Indian J Pharmacol 2020;52(1):1–5. DOI: 10.4103/ijp.IJP_119_20.
  46. Li G, Clercq ED. Therapeutic options for the 2019 novel coronavirus (2019-nCoV). Nat Rev Drug Discov 2020;19(3):149–150. DOI: 10.1038/d41573-020-00016-0.
  47. Tai DY. Pharmacologic treatment of SARS: current knowledge and recommendations. Ann Acad Med Singapore 2007;36(6):438–443.
  48. Morgenstern B, Michaelis M, Baer PC, Doerr HW, Cinatl Jr J. Ribavirin and interferon-beta synergistically inhibit SARS-associated coronavirus replication in animal and human cell lines. Biochem Biophys Res Commun 2005;326(4):905–908. DOI: 10.1016/j.bbrc.2004.11.128.
  49. Neuraminidase inhibitors for treatment of influenza A and B infections. MMWR Recomm Rep 1999;48(RR-14):1–9.
  50. Al-Abdely HM, Midgley CM, Alkhamis AM, Abedi GR, Lu X, Binder AM, et al. Middle East respiratory syndrome coronavirus infection dynamics and antibody responses among clinically diverse patients, Saudi Arabia. Emerg Infect Dis 2019;25(4):753–766. DOI: 10.3201/eid2504.181595.
  51. Dayer MR, Taleb-Gassabi S, Dayer MS. Lopinavir; a potent drug against coronavirus infection: insight from molecular docking study. Arch Clin Infect Dis 2017;12:e13823. DOI: 10.5812/archcid.13823.
  52. Oldfield V, Plosker GL. Lopinavir/ritonavir: a review of its use in the management of HIV infection. Drugs 2006;66(8):1275–1299. DOI: 10.2165/00003495-200666090-00012.
  53. Kim UJ, Won EJ, Kee SJ, Jung SI, Jang HC. Combination therapy with lopinavir/ritonavir, ribavirin and interferon-alpha for Middle East respiratory syndrome. Antivir Ther 2016;21(5):455–459. DOI: 10.3851/IMP3002.
  54. Sheahan TP, Sims AC, Leist SR, Schäfer A, Won J, Brown AJ, et al. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun 2020;11(1):222. DOI: 10.1038/s41467-019-13940-6.
  55. Agostini ML, Andres EL, Sims AC, Graham RL, Sheahan TP, Lu X, et al. Coronavirus susceptibility to the antiviral remdesivir (GS-5734) is mediated by the viral polymerase and the proofreading exoribonuclease. mBio 2018;9(2):e00221-18. DOI: 10.1128/mBio.00221-18.
  56. Yamamoto N, Yang R, Yoshinaka Y, Amari S, Nakano T, Cinatl J, et al. HIV protease inhibitor nelfinavir inhibits replication of SARS-associated coronavirus. Biochem Biophys Res Commun 2004;318(3):719–725. DOI: 10.1016/j.bbrc.2004.04.083.
  57. Khamitov RA, Loginova S, Shchukina VN, Borisevich SV, Maksimov VA, Shuster AM. Antiviral activity of arbidol and its derivatives against the pathogen of severe acute respiratory syndrome in the cell cultures. Vopr Virusol 2008;53(4):9–13.
  58. Robbins RA, Grisham MB. Nitric oxide. Int J Biochem Cell Biol 1997;29(6):857–860. DOI: 10.1016/S1357-2725(96)00167-7.
  59. Barnes PJ. Nitric oxide and airway disease. Ann Med 1995;27(3): 389–393. DOI: 10.3109/07853899509002592.
  60. Rossaint R, Gerlach H, Schmidt-Ruhnke H, Pappert D, Lewandowski K, Steudel W, et al. Efficacy of inhaled nitric oxide in patients with severe ARDS. Chest 1995;107(4):1107–1115. DOI: 10.1378/chest.107.4.1107.
  61. Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. Lancet 2020;395(10223):473–475. DOI: 10.1016/S0140-6736(20) 30317-2.
  62. Pei J, Sekellick MJ, Marcus PI, Choi IS, Collisson EW. Chicken interferon type I inhibits infectious bronchitis virus replication and associated respiratory illness. J Interferon Cytokine Res 2001;21(12):1071–1077. DOI: 10.1089/107999001317205204.
  63. Turner RB, Felton A, Kosak K, Kelsey DK, Meschievitz CK. Prevention of experimental coronavirus colds with intranasal alpha-2b interferon. J Infect Dis 1986;154(3):443–447. DOI: 10.1093/infdis/154.3.443.
  64. Kuri T, Zhang X, Habjan M, Martínez-Sobrido L, García-Sastre A, Yuan Z, et al. Interferon priming enables cells to partially overturn the SARS coronavirus-induced block in innate immune activation. J Gen Virol 2009;90(Pt 11):2686–2694. DOI: 10.1099/vir.0.013599-0.
  65. Zhao Z, Zhang F, Xu M, Huang K, Zhong W, Cai W, et al. Description and clinical treatment of an early outbreak of severe acute respiratory syndrome (SARS) in Guangzhou, PR China. J Med Microbiol 2003;52(Pt 8):715–720. DOI: 10.1099/jmm.0.05320-0.
  66. Bussel JB, Szatrowski TP. Uses of intravenous gammaglobulin in immune hematologic disease. Immunol Invest 1995;24(1–2):451–456. DOI: 10.3109/08820139509062794.
  67. Dalakas MC, Clark WM. Strokes, thromboembolic events, and IVIg: rare incidents blemish an excellent safety record. Neurology 2003;60(11):1736–1737. DOI: 10.1212/01.WNL.0000074394.15882.83.
  68. Vincent MJ, Bergeron E, Benjannet S, Erickson BR, Rollin PE, Ksiazek TG, et al. Chloroquine is a potent inhibitor of SARS coronavirus infection and spread. Virol J 2005;2:69. DOI: 10.1186/1743-422X-2-69.
  69. Richardson P, Griffin I, Tucker C, Smith D, Oechsle O, Phelan A, et al. Baricitinib as potential treatment for 2019-nCoV acute respiratory disease. Lancet 2020;395(10223):e30–e31. DOI: 10.1016/S0140-6736(20)30304-4.
  70. Sachse G, Willms B. Efficacy of thioctic acid in the therapy of peripheral diabetic neuropathy. Horm Metab Res Suppl 1980;9:105–107.
  71. Wu YH, Tseng CP, Cheng ML, Ho HY, Shih SR, Chiu DTY. Glucose-6-phosphate dehydrogenase deficiency enhances human coronavirus 229E infection. J Infect Dis 2008;197(6):812–816. DOI: 10.1086/528377.
  72. Li Q, Zhao Z, Zhou D, Chen Y, Hong W, Cao L, et al. Virucidal activity of a scorpion venom peptide variant mucroporin-M1 against measles, SARS-CoV and influenza H5N1 viruses. Peptides 2011;32(7):1518–1525. DOI: 10.1016/j.peptides.2011.05.015.
  73. te Velthuis AJ, van den Worm SH, Sims AC, Baric RS, Snijder EJ, van Hemert MJ. Zn(2+) inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture. PLoS Pathog 2010;6(11):e1001176. DOI: 10.1371/journal.ppat.1001176.
  74. Zumla A, Hui DS, Azhar EI, Memish ZA, Maeurer M. Reducing mortality from 2019-nCoV: host-directed therapies should be an option. Lancet 2020;395(10224):e35–e36. DOI: 10.1016/S0140-6736(20)30305-6.
  75. Rogosnitzky M, Berkowitz E, Jadad RA. No time to waste: real-world repurposing of generic drugs as a multifaceted strategy against COVID-19. JMIR Preprints 2020;1:28.
  76. A Pilot Study of Sildenafil in COVID-19 - ClinicalTrials.gov. 2020.
  77. Jeon S, Ko M, Lee J, Choi I, Byun YS, Park S, et al. Identification of antiviral drug candidates against SARS-CoV-2 from FDA-approved drugs. Antimicrob Agents Chemother 2020. AAC.00819-20. DOI: 10.1128/AAC.00819-20.
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